The Effects of PTSD on Treatment Adherence, Drug Relapse, and Criminal Recidivism in a Sample of Incarcerated Men and Women

Kubiak, Sheryl Pimlott

doi:10.1177/1049731504265837

Cited by 104 publications

(97 citation statements)

References 36 publications

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“…In humans, it has been repeatedly reported that individuals that are comorbid for PTSD and SUDs do not differ from individuals with SUDs alone in substance use severity (Brown Stout and Mueller 1999;Eggleston et al 2009), but are more likely to relapse (Tate Brown Unrod and Ramo 2004;Kubiak 2004;Burns et al 2010;Najt Fusar-Poli and Brambilla 2011). This is corroborated by the findings in our experiments of no differences in acquisition or maintenance between previously shocked or unshocked rats, but shocked rats showed greater reinstatement after successful extinction.…”

Section: Discussionsupporting

confidence: 82%

Persistent effects of acute stress on fear and drug-seeking in a novel model of the comorbidity between post-traumatic stress disorder and addiction

2017

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Even following long periods of abstinence, individuals with anxiety disorders have high rates of relapse to drugs of abuse. Although many current models of relapse demonstrate effects of acute stress on drug-seeking, most of these studies examine stressful experiences that occur in close temporal and physical proximity to the reinstatement test. Here, we assess the effects of a stressful experience in one context on fear and drug-seeking in a different context. We adapt the stress-enhanced fear learning procedure to examine impacts on drug-seeking long after the stressful experience occurred. We find massive footshock in a distinct environment produced an acute increase in corticosterone, long-term hyper-responsivity to a single shock in different contexts with extensive histories of drug-seeking behaviors, enhancements in cocaineinduced conditioned place preference in mice, and persistent enhancements in cue-induced reinstatement of methamphetamine-seeking behavior in rats. Together, these experiments demonstrate that an acute trauma causes persistent changes in responsivity to mild stressors and drug-seeking behavior in other contexts, which mirrors aspects of the comorbidity between post-traumatic stress disorder and substance use disorders. These behavioral approaches provide novel procedures for investigating basic mechanisms underlying this comorbidity and they provide powerful tools for testing preclinical pharmacological and behavioral interventions. [Supplemental material is available for this article.]Compared with the general population, individuals diagnosed with post-traumatic stress disorder (PTSD) have higher rates of substance use disorders (SUDs) (Stewart 1996;McFarlane 1998;Ouimette et al. 1998;Back et al. 2000;Sonne et al. 2003;McCauley et al. 2012;Tipps et al. 2014;Roberts et al. 2015) and are twice as likely to use methamphetamine (METH) than are individuals with trauma exposure that does not lead to PTSD (Smith et al. 2010). Individuals with PTSD are also more likely to relapse to drugs of abuse when cues associated with drug-seeking are encountered, even long after periods of acute stress have ended (Bradizza et al. 2006), suggesting stressors that are temporally and contextually dissociated from drug-seeking may induce longterm changes that contribute to an increased risk for relapse.It has long been observed that stress is a potent inducer of reinstatement (an animal model of relapse) in rodents (e.g., Shaham et al. 2000;Erb et al. 2001;Sanchez and Sorg 2001;Boutrel et al. 2005;Redila and Chavkin 2008;Schindler et al. 2010). Although the ability of stress to induce reinstatement has been well established in the literature, most studies have focused on effects when the organism is tested in a state of acute stress within the drug-seeking context; few studies have evaluated the persistent effects of an acute stressor long after the stress has ended. Individuals with PTSD have traumatic experiences long before relapse and are unlikely to use drugs in the trauma-associated context; avoiding ...

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Section: Discussionsupporting

confidence: 82%

Persistent effects of acute stress on fear and drug-seeking in a novel model of the comorbidity between post-traumatic stress disorder and addiction

2017

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“…Research also suggests that the high incidence of drug-related crimes and substance abuse, combined with the extensive trauma histories of women, is largely responsible for high recidivism rates (Bill, 1998;Garcia-Coll et al, 1997;Kubiak, 2004).…”

Section: Trauma Andsubstance Abuse Among Incarcerated Women Prevalencementioning

confidence: 99%

“…Several researchers have taken the theoretical position that the high incidence of drugrelated crimes and substance abuse, combined with inadequate treatment for the extensive trauma histories of women in prison, is largely responsible for high recidivism rates (Bill, 1998;Garcia-Coll et al, 1997;Kubiak, 2004;Zlotnick et al, 2003). Previous research, focusing on the prevalence of traumatic events in the lives of incarcerated women, found that 78% to 85% of these women experienced at least one trauma in their lifetimes (Browne et al, 1999;Pomeroy, 1998;Kane & DiBartolo, 2002).…”

Section: Restatement Ofthe Problemmentioning

confidence: 99%

Risk and Protective Factors in Mothers With a History of Incarceration: Do Relationships Buffer the Effects of Trauma Symptoms and Substance Abuse History?

Walker¹

2011

Women & Therapy

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“…Furthermore, Kubiak (2004) investigated the effects of PTSD on outcomes for incarcerated men and women who were involved in a prison rehabilitation program. Although men with PTSD were more likely to enter community aftercare treatment than those without PTSD, drug screens after release from prison showed a significantly higher rate of drug relapse and a higher rate of recidivism in those with PTSD.…”

Section: Discussionmentioning

confidence: 99%

“…PTSD is known to influence treatment adherence rates, with higher levels of PTSS being predictive of both lower adherence to treatment, and lower treatment retention (Najavits & Hien, 2013;Kubiak, 2004) Furthermore, higher levels of PTSS predict substance use relapse (Norman, Take, Anderson, & Brown, 2007;Ford, Hawke, Alessi, Ledgerwood, & Petry, 2007). This influence on treatment and relapse makes PTSD prohibitive of successful SUD treatment, especially as time spent in treatment is one of the only known predictors of treatment success in drug and alcohol rehabilitation (Hubbard, Craddock, & Anderson, 2003).…”

Section: Treating Ptsd and Sud Concurrentlymentioning

confidence: 99%

Posttraumatic stress disorder in a therapeutic community for substance use disorders: an evaluation of the influence

Perryman¹

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The purpose of this body of research is twofold. First, to investigate posttraumatic stress disorder (PTSD) in a sample of adults undergoing substance use disorder (SUD) treatment in a therapeutic community (TC) and, second, to apply major psychological theories to help understand the nature of this comorbidity in ways that inform treatment. The focal theories of this research are: emotion dysregulation (Gratz & Roemer, 2004), and revised Reinforcement Sensitivity Theory (rRST; Corr, 2008;Gray & McNaughton, 2000). Rash Impulsiveness will be included as an important dimension of rRST that has been consistently linked to substance misuse. Chapter 1 presents an overview of research related to the thesis as a whole. In Chapter .72, p < .00). Furthermore, the correlations between PTSS and two of the facets of rRST, BAS and fight-flight-freeze sensitivity (FFFS), were significantly correlated (r = -.23 and .49, p < .01, respectively). BAS sensitivity was shown to negatively correlate with PTSS, indicating that lower BAS sensitivity related to higher PTS severity. No relationship was found between the Behavioural Inhibition System (BIS) and PTSS. Finally, Rash Impulsivity significantly correlated with PTSS at intake, r = .50, p < .00. Contrary to hypotheses, and previous research, Rash Impulsivity did not significantly correlate with retention. Theoretical mechanisms linking PTSS and substance misuse were investigated further, with tests of theoretical models in which individual difference factors (facets of the rRST) were related to retention and outcomes from treatment, and facets of emotional dysregulation were tested as mediators of this relationship. Upon investigation through linear regression, no suitable variable was found the mediate the relationship between PTSS and retention.iii The final moderated mediated model, therefore, was not suitable for this population. Limited moderation, though, occurred between the two facets of rRST and retention. Specifically, investigation of the simple slopes showed that FFFS and Rash Impulsivity both moderate the relationship between PTSD and retention at high (+1 SD) and mean scores. These findings indicate that high levels of both facets do interact with PTSD to negatively influence treatment retention.The null findings for both mediation and the moderated mediation model contradict previous research, and may be due to homogeneity in scores across the population. Overall, some implications for treatment can be extrapolated. First, PTSD is highly prevalent in the TC population, and should be assessed using psychometrically valid measures, such as the PCL-C, and addressed in treatment. Second, treatment for SUD does not exacerbate PTSD; on the contrary, PTSS significantly decreased during TC treatment. Finally, as there is solid theoretical support to suggest an influence of emotion dysregulation and Rash Impulsiveness on retention and outcomes, more research needs to be conducted on the role of these two constructs with the intent of creating a better suited rehabi...

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The Effects of PTSD on Treatment Adherence, Drug Relapse, and Criminal Recidivism in a Sample of Incarcerated Men and Women

Cited by 104 publications

References 36 publications

Persistent effects of acute stress on fear and drug-seeking in a novel model of the comorbidity between post-traumatic stress disorder and addiction

Persistent effects of acute stress on fear and drug-seeking in a novel model of the comorbidity between post-traumatic stress disorder and addiction

Risk and Protective Factors in Mothers With a History of Incarceration: Do Relationships Buffer the Effects of Trauma Symptoms and Substance Abuse History?

Posttraumatic stress disorder in a therapeutic community for substance use disorders: an evaluation of the influence

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